Keywords

Quality Of Work Life, Job Burnout Women's And Children's Hospital In Al-Diwaniyah.

Introduction

When it comes to job burnout, it can lead to a reduced quality of working life. We often find workers stuck in a vicious cycle of job burnout and unable to invest time in a way that benefits the organization or find balance. This in turn can lead to burnout, feelings of helplessness and hopelessness, as well as It can lead to low motivation and low job satisfaction, which leads to an unhealthy work environment. Job burnout is a state of mental and physical fatigue caused by the increased stress accumulated on the individual within the workplace. This includes work pressure caused by the responsibilities imposed on them, not getting enough recognition for their work, lack of balance between work and personal life, lack of an appropriate style of communication within the organization, and many other factors. Thus, the key to avoiding burnout is to ensure that quality of work life is prioritized as essential to maintaining a work-life balance. Also, the workplace can lead to a lack of job security and ever-increasing workloads, and this leads to job exhaustion, leaving employees feeling exhausted and sluggish at work. Pressure on workers to get work done can often cause employees to lose the importance of balance between work. And life, which leads to a decrease in the quality of life, and this can lead to the increasing effects of job burnout in a devastating way, which leads to physical and mental health problems. In addition, when employees are unable to manage workloads and deadlines, they may engage in coping mechanisms that directly affect the performance of the organization. From this standpoint, the idea of the current research came to highlight two important variables: burnout and quality of work life. next paragraph.

Research Methodology

Research Problem

Many organizations have become in urgent need of Concern for the quality of work life because of its impact on the individuals working for it and to take into account the causes and factors that reduce and affect the quality of life, as one of the reasons for reducing the quality of work life for nurses, the research sample, is the pressure exerted on them in health care This is a problem that can cause exhaustion and fatigue, and the nurses may feel frustrated, tired and depressed, and many factors can lead to this type of psychological and emotional stress. A decrease in the quality of work life and a decrease in job satisfaction and working conditions, which may cause a lack of adherence to achieving the objectives of the organization and the desire to leave and change the workplace whenever the opportunity arises. This trend can be translated into the following questions:

1. What is the prevailing level of job burnout in the hospital under study?
2. Which of the dimensions of quality of work life (QWL) is most affected by burnout in the hospital, the research sample?
3. Is the relationship between job burnout and the quality of work life an inverse and negative relationship?
4. Do the dimensions of job burnout affect achieving the quality of work life of nurses in the research sample hospital?.

Study Objectives

The Study Includes a Set of Objectives, as Follows

1. Presenting a theoretical framework that explains the nature of the negative relationship between job burnout and its impact on the quality of work life.
2. Detecting the perceived burnout level in the target sample.
3. To identify the availability of the quality of work life from the point of view of the research sample nurses.
4. Testing the relationship between burnout and its impact on the quality of work life.
5. Testing the effect of job burnout on the quality of work life.

Research Importance

1. The research contributes to providing clear guidance to decision makers in the hospital research sample as well as local organizations in the field of addressing the problem of job burnout.
2. This research is organized into other research efforts in enriching the theoretical and cognitive side, as well as its contributions to supporting other research in this field.
3. The contribution of this research in drawing a clear path for the organization, the research sample, about the reasons for the low quality of work life, and increasing the awareness of the hospital management under study of the importance of knowing the necessary measures that reduce the practice of job burnout and raise the level of quality of work for the nurses, the research sample.

Research Hypotheses

H₁: (There is a significant inverse correlation between job burnout in terms of (Emotional Exhaustion, Depersonalization, Lack of Personal accomplishment) and the quality of work life in terms of (Job and career satisfaction, General well-being, Homework interface, Stress at work, Control at work, Working conditions)).
H₂: (Job burnout has a significant effect on the quality of work life in its dimensions (Job and career satisfaction, General well-being, Homework interface, Stress at work, Control at work, Working conditions)).

The Hypothetical Model for the Study

The Figure below Presents the Hypothetical model of the Study

Review of Literature

Job Burnout

The concept of job burnout was used for the first time to describe a group of symptoms that result from chronic organizational stress experienced by social service employees. With this issue significantly on a larger scale it is alleged that burnout can affect representatives of professions who cannot deal with the strong emotions associated with their work (Moczyd?owska, 2016). Job burnout is a situation that results from frequent exposure to work-related stress, which is characterized by well-known physical, emotional and mental exhaustion. Job burnout continues to affect many workers in many organizations, and this situation affects the performance of institutions in addition to causing undesirable effects on employees. Its manifestations include withdrawal symptoms, interpersonal arguments, low performance, family problems, and health issues (Breso et al., 2007). Therefore, all managers need to implement appropriate strategic plans that will help them provide a conducive workstation environment to protect employees from facing problems associated with burnout situations, This problem can be seen in human society and the workplace, as job burnout depends on constant stress and fatal job exhaustion (Lubbadeh, 2020). It can even make individuals feel a lack of energy and the need to maintain their job position and job burnout is often common in jobs that are spent directly with their clients or They have direct contact with them, and they also face an enormous amount of psychological pressure. These factors can lead to suffering from the tensions of job burnout that eventually It causes a deterioration in the quality of work life and service delivery (Gorji, 2011).

Job burnout is a very common phenomenon in assisting professions, including nursing, as it can cause physical and psychological damage, reduce work efficiency and motivation of individuals that leads to a sharp decrease in the quantity and quality of care services (Rezaei, 2015). One of the most prominent definitions describing burnout as a “syndrome of emotional burnout.” depersonalization, and decreased personal achievement that can occur among individuals who work with people in some class (Korunka et al., 2010). Maslach & Jackson (1981) defined “burnout” as a syndrome of emotional burnout, depersonalization Decreased personal achievement It also takes the form of a physical, emotional, and psychological response to work-related stress Physical symptoms may include decreased energy and chronic fatigue Laschinger and coworkers “burn out ” as a phenomenon commonly associated with working conditions at lower levels of autonomy, toward, lack of control over work practices, non-existent collaborative work relationships and lack of organizational trust (Bhanugopan & Fish, 2006). It is also defined as a permanent work-related negative condition that occurs in the case of healthy people in general (Maslach et al., 2001). Burnout syndrome is characterized by exhaustion accompanied by psychological and physical discomfort, a feeling of diminished effectiveness, decreased motivation, and ineffective attitudes and behaviors at work. This condition develops gradually and arises from contradictions between expectations and the reality of life. Occupational burnout often has a self-powered, automatic nature due to the lack of effective stress coping strategies (Moczyd?owska, 2016).

Dimensions of Job Combustion

This variable was measured using the scale he developed Maslach & Jackson (1981) consists of three dimensions: emotional exhaustion, depersonalization, and personal achievement. Most researchers agreed on its use (Bhanugopan & Fish, 2006).

Emotional Exhaustion

Exhaustion caused by work and the unwillingness to invest any other emotion in the work (Wu et al., 2019). They are able to give back to themselves on a psychological level (Maslach & Jackson, 1981). As well as being emotionally exhausted as if they lack adaptive resources and can't do more for their jobs. The energy they had to devote to their work has now been depleted, leaving them without the necessary resources to perform their work (Halbesleben & Buckley, 2004).

Depersonalization

It refers to negative, sarcastic, or overly detached responses to other people at work, and depersonalization is the personal component of burnout. Depersonalization (also known as cynicism and disengagement in the literature) often occurs in response to the emotional exhaustion mentioned above and describes a process in which employees disengage from their jobs and begin to develop callous or indifferent attitudes toward their job and performance Halbesleben & Buckley (2004) and This dimension appears through negative attitudes of workers towards other individuals as well as a low ability to respond to their needs (Skaalvik & Skaalvik, 2020). It is related to the somewhat negative responses of individuals towards different working conditions that cause the creation of a negative viewpoint, the feeling of not being accepted and ultimately creating a gap between the individuals and their jobs (Gorji, 2011).

Lack of Personal Accomplishment

It is the final stage of burnout, when employees are completely exhausted and need clinical care with a sense of failure. And the employee destructively evaluates his abilities and achievements in the workplace. This stage includes two aspects, the ability to work, and achievement in the work of the individual. The worker negatively evaluates his achievements in professional life Suwandi & Tentama (2020).The individual feels dissatisfied with himself and dissatisfied with his work (Leitão et al., 2019). Despair continues with inefficiency, low self-confidence, and inability to handle work pressures. Then the employee feels despair, which leads to low self-esteem, lack of ability, and low efficiency Zaid (2019 ), as it creates diminishing perceptions of the individual’s ability to perform the job, as employees realize that they cannot perform their work as they could before (Halbesleben & Buckley, 2004).

Quality of Work Life

The history of the emergence of the quality of working life and the development of its regulations began in the early twentieth century in order to preserve the safety of workers from injuries and work risks, as the first step was identified between the years (1930-1940) before the trade union movement, as the focus was mostly on job security Hamad (2018) and is considered one of the first to address the issue of the quality of working life Easton & Van Laar (2013). and in 1974 the issue of the quality of working life was reconsidered by researchers due to the global energy crisis and inflation, so it is derived from the total quality that developed in Japan, where management techniques were introduced to ensure this (Fernandes et al., 2017). In the year Hackman realized that a work environment that is able to provide for the personal needs of its employees will lead to positive results and an excellent quality of life (Daniel, 2019). Usually, the employee is easily attracted to organizations that offer a better quality of work life and stay in it in addition to an appropriate environment (Ampofo & Dartey-Baah, 2016). The quality of working life in its broad sense is used to refer to management philosophy that enhances the dignity of its employees and changes in the organization's culture that increase well-being and job satisfaction. It also arises when there is a balance between the needs of the working individuals and the efforts of the organization with the aim of making the working individuals feel happy, comfortable and enjoying their work. Thus, these conditions can provide the working individuals with opportunities to develop themselves and their organizations (Adikoeswanto et al., 2020). The quality of working life represents the relationship between employees and the overall work environment and one of the most exciting ways to create motivation, and it is a way to enrich jobs (Nanjundeswaraswamy & Swamy, 2013). It is also noted that fair wages and opportunities for continuous growth and promotion It improves employee performance, which in turn leads to an increase in the quality of working life for working individuals (Swamy et al., 2015). Although there is no definition agreed upon by most researchers on the quality of working life, they agree that the quality of working life is related to the well-being of workers Adikoeswanto et al. (2020) the quality of work life is defined as the degree to which employees can actively shape their jobs according to their choices, interests and needs (Shahbazi et al., 2011). It is also defined as a process of redesigning the job by considering the employee as an asset and not as a liability Nanjundeswaraswamy & Swamy (2013) and defined the quality of working life in different ways. For employees, it is a subset of the broad concept of quality of life. It is an industrial democracy that promotes participatory management style in decision-making procedures. For managers and administrators, it is considered an aspect. Psychologically, it leads to higher productivity, on the other hand, unions and workers defined it as those that improve social relations in the workplace as is the degree to which individuals can meet their critical personal needs such as the need for autonomy while working in an organization (Riyono et al., 2022).

Dimensions of Quality Work Life

Literary reviews on the quality of working life indicate that it is a multidimensional structure, and most researchers have agreed that the following six dimensions can be used to measure the quality of working life according to a scale (Easton & Van Laar, 2013).

Job and Career Satisfaction

The quality of work provides satisfaction to employees within the work environment, and thus employees will spread their full dedication throughout the organization, and thus productivity improves and loyalty to the organization increases through their positive participation towards their organization. Dissatisfaction with work life is a problem that affects almost all workers in At one time or another, it may cause disappointment and resentment, and thus affect the individual and the organization (Ampofo & Dartey-Baah, 2016).

General Well-Being

Providing well-being in the workplace can modify the quality of work life and increase the social l interaction of employees and their physical activity (Lento et al., 2019) and the low well-being of individuals can cause fatigue, headaches and nausea, which can escalate to serious diseases in the future, so the level Low welfare is estimated at a cost of )5-10%( of the national product annually (Daniel, 2019).

Stress at work

Work pressure can be a source of stress and anxiety for the employees as it can happen when the employee feels that there are a lot of responsibilities that need to be completed in a limited period of time, or when the tasks assigned to him are difficult or complex (Easton & Van Laar, 2013).

Homework Interface

It is the process of reconciliation between family and work obligations, that is, work can facilitate family life and the family can facilitate working life (Frone, 2003).

Control at Work

Control refers to the extent to which the employee feels able to directly influence the work environment surrounding them. Employees who have a high degree of control over their work will enjoy the freedom to exercise their personal initiative and issue their judgments through setting goals and responsibilities for their work (i.e., tasks or which projects they should work on) ? and how their work should be done (i.e. which methods should be used (Lapierre & Allen, 2012).

Working Conditions

Working conditions are related to the physical working environment of the personnel that characterize them; The employee's sense of happiness in work conditions and the extent of the employee's satisfaction with basic needs, work conditions and security in performing work effectively (Suwand & Tentama, 2020).

Statistical Analysis

A Population and study sample and a Data Collection Tool

The research data was collected from one of the government hospitals in Al-Diwaniyah Governorate, which is the Women and Children's Hospital, where the target sample was the nursing staff of women working in the hospital and their task is to care for patients. During an interview with some, it was found that many nurses suffer from job burnout and from work stress and workload, which leads to a sharp decrease in the quantity and quality of care services they provide, and thus affects their interaction with patients. This context is suitable for testing the default search model. See Figure (1) The above-mentioned.

The sample was selected according to Comery and Lee 1992, (a sample with less than 50 members would be a weaker sample; a sample size of 100 would not be good; 200 would be sufficient; a sample of 300 considered large; 500 in general would be excellent although 1000 It would be great.) Therefore, the current research sample size of (544) respondents was determined. After distributing the questionnaire to the research sample represented by (544 nurses) in the hospital, and during the examination of the forms it became clear that there were (114) incomplete answers that were excluded. Thus, (430) became a valid model for data analysis (Bakker et al., 2002).

Measures

Job Burnout

The Maslach Burnout Scale was used to investigate and study the state of job burnout of the target sample in the Women's and Children's Hospital. The dimensions of job burnout used in this research included three dimensions (Emotional Exhaustion, Depersonalization, Lack of Personal accomplishment), and the seven-point Likert scale (0= never to 6= every day ) was used to measure (22) items.

Quality of Work Life

This variable consists of six dimensions based on a study (Easton & Laar, 2013) that were used in the current research by (23) items (Job and career satisfaction, General well-being, Homework interface, Stress at work, Control at work, Working conditions) according to a seven-point Likert Scale ( 1=Very untrue to 7= Very True).

The process of testing the validity and credibility of the research metrics is a very important step for the purpose of obtaining accurate results, and in order to reach these results, we must verify two basic criteria, namely (Reliability) and (Validity). The standards used previously in the management literature, which are characterized by stability and high credibility, were relied upon. A test was conducted to verify the structural stability of the measurement tool of the current research by calculating the reliability coefficient of the measures using Cronbach's alpha correlation coefficient using the (SPSS. 24) program shown in Table (1).

Table 1 Cronbach Alpha Coefficients For Search Variables
Var.	Cronbach's Alpha for Var.	Dimension	Cronbach's Alpha for dimension
job burnout	0.803	Emotional Exhaustion	0.792
		Depersonalization	0.854
		Lack of Personal accomplishment	0.799
Quality of Work Life	0.817	Job and career satisfaction	0.844
		General well-being	0.798
		Homework interface	0.786
		Stress at work	0.887
		Control at work	0.858
		Working conditions	0.863

All values of Cronbach's alpha coefficient were greater than (0.75) and this indicates its statistical acceptance in administrative and behavioral research according to the study and therefore the current research measures are characterized by internal stability.

Descriptive Analysis of Research Data

The researcher conducted a descriptive analysis required for the research variables according to the appropriate statistical means for the research data, which are the arithmetic mean and the standard deviation as shown in the table (2,3) below

Table 2 Own Statistics With Job Burnout
Dimensions	Means	SD.
Emotional Exhaustion	3.621	1.286
Depersonalization	3.402	1.187
Lack of Personal accomplishment	3.511	1.163
Average	3.511	1.212

1. Job burnout

It is the statistical description of a variable job burnout which displays the table 2.

By examining the data contained in the light of the presentation presented above related to the statistical description, which includes the responses of the sample members in the various values of the dimensions of the burn-out variable, it is clear that the most frequently present in the hospital, which constitutes a burden on nurses, is the dimension (Emotional Exhaustion ) which obtained an arithmetic mean (3.621 ) and a standard deviation (1.286 ) and at a high level after (Lack of Personal accomplishment ) which was the arithmetic mean ( 3.511) and the standard deviation (1.163 )and at a high level also and another dimension was for (Depersonalization ) and at a high level with a mean (3.402 ) and a deviation (1.187 ). This explains the consistency of the answers of the research sample nurses. The figure (2) below shows the dimensions of the variable job burnout according to the arithmetic mean (Mohamed et al., 2020).

Quality of Work Life

The table 3. presents the arithmetic mean and standard deviations for a variable Quality of Work Life.

Through Table (3) of the responses of the research sample individuals to the quality of work life variable, we find that its dimensions range from low to high, as the (Homework interface) dimension has ranked first with a high level with an average of (3.425) and a standard deviation of (0.979), while the least dimension Presence in the Women's and Children's Hospital was for the (Working conditions) dimension, as it obtained a low response with a mean of (2.053) and a deviation of (1.254), and this indicates the consistency of the answers of the sample. Figure 3 shows the levels of dimensions of the quality of work life.

Table 3. Own Statistics With Quality Of Work Life
Dimensions	Means	Sd.
Job and career satisfaction	2.751	1.212
General well-being	3.043	1.355
Homework interface	3.425	0.979
Stress at work	3.316	1.313
Control at work	3.124	1.296
Working conditions	2.053	1.254
Average	2.952	1.239

Hypothesis Testing

Correlation hypothesis

Table No. (4) shows the correlation coefficients between the research variables of job burnout and quality of work life.

Through the table (4) it is clear that there is a significant negative correlation between job burnout and its dimensions and the quality of work life and its dimensions, and this indicates the existence of a linear correlation between the variables in preparation for the use of path analysis, as well as proves the validity of the first main hypothesis, and this indicates that the research sample nurses feel dissatisfaction, frustration and constant fatigue At work, loss of passion and enthusiasm, and this causes in turn to reduce productivity and achievements at work and to a reduction in the quality of work life. Thus, the first main hypothesis is accepted.

Table 4 Correlations Matrix
Var.	X	X1	X2	X3
QWL	-0.426**	-0.487**	-0.325*	-0.401*
JCS	-0.426**	-0.563**	0.424**-	-0.563*
GWB	-0.426**	-0.438*	0.388**-	-0.433**
HWF	-0.426**	-0.512*	-0.430**	-0.542*
SAW	-0.426**	-0.433**	.401**0-	0.632**-
CAW	-0.426**	-0.481*	-0.352*	-0.45
WCS	-0.426**	-0.477*	.413**0-	-0.435*
Note. (X= job burnout, X1=Emotional Exhaustion, X2= Depersonalization, X3= Lack of Personal accomplishment, QWL= Quality of Work Life, JCS= Job and career satisfaction, GWB=General well-being, HWF=Homework interface, SAW=Stress at work, CAW=Control at work, WCS=Working conditions . * Correlation is significant at the 0.05 level (2-tailed). ** Correlation is significant at the 0.01 level (2-tailed).

Effect Hypotheses

Table 5 shows the results of testing the effect hypothesis, as this hypothesis focuses on the effect relationship between job burnout and its exclusion on the quality of work life and its exclusion. The results of Table (5) also indicate that functional burnout by its exclusion (Emotional Exhaustion, Depersonalization, Lack of Personal accomplishment) contributes to the interpretation of (62%) of the change in the quality of work life and (38%) is due to the intervention of other factors not included in the statistical model. The value of (F = 18.475, P < 0.01) confirms the presence of significant significance in explaining the quality of work life through the concept of job burnout. In light of the foregoing, this result provides support for the direction of the second main hypothesis.

Table 5 Results Of Multiple Regression Analysis To Test The Second Main Hypothesis
Dependent Variable	Independent Variable	B	T	Sig	R2	F
Quality of Work Life	Emotional Exhaustion	0.279**	3.434	0.001	0.62	18.475**
	Depersonalization	0.105*	2.088	0.039
	Lack of Personal accomplishment	0.420**	4.989	0
* Correlation is significant at the 0.05 level (2-tailed).
** Correlation is significant at the 0.01 level (2-tailed).

The above result explains that job burnout has an effect on the low quality of life at work, and this causes high psychological pressure and lack of support and cooperation between nurses in the workplace, as well as causes an imbalance between professional and personal life, which in turn causes high levels of stress.

Conlcusions and Recommendations

Conclusions

Theoretical Results

1. Burnout is a common condition among workers and involves feelings of psychological fatigue, discomfort, exhaustion and nervousness in the work environment.
2. Many factors that lead to job burnout can be studied, such as lack of confidence in the manager or official, disadvantages of career planning, poor relations between colleagues, and difficulty at work.
3. Imbalance between professional and personal life Sometimes, working with high levels of stress can have a negative impact on the private life of hospital workers.
4. Quality in work life can have significant impacts on the psychological and physical health of workers.

Practical Results

1. It became clear through the answers of the research sample nurses to the job burnout variable that after emotional exhaustion, the nurses were mostly inside the hospital through exposure to many pressures and psychological challenges, bad mood, or weak psychological state.
2. The preferences and desires of the nurses within the hospital towards the quality of work life indicated an imbalance between professional and personal life: Sometimes, working with high levels of stress can lead to a negative impact on the private lives of hospital staff.
3. The results of the research also indicated that there is a negative relationship between job burnout and the quality of work life.
4. The results of the research showed that job burnout is explained by (62%) the change that nurses have towards work through a feeling of boredom and dissatisfaction with working life, and it may also lead to high levels of stress and work pressures, and this can negatively affect mental and physical health and lead to loss of people Paying attention to several aspects of their personal lives, which negatively affects the quality of their social and emotional lives.

Recommendations

1. Treatment of job burnout requires, in particular, increasing independence at work, reducing occupational pressure, improving appropriate choices, supporting relationships between individuals, and reshaping job challenges and work difficulties through a correct management methodology and workflow.
2. A fair system must be provided that guarantees equal opportunities for all hospital workers, and rewards and appreciation are given to workers who provide the best services.
3. Working hours must be respected and workers must be given adequate rest to maintain their health and safety.
4. Hospital workers need to support each other, including teamwork and joint work, to ensure that patients receive the best healthcare.

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Received: 03-May-2023, Manuscript No.JMIDS-23-13556; Editor assigned: 05-May-2023, Pre QC No. JMIDS-23-13556(PQ); Reviewed: 18-May-2023, QC No. JMIDS-23-13556; Revised: 21-May-2023, Manuscript No. JMIDS-23-13556(R); Published: 26-May-2023